Pancreatic family history does not predict disease progression but connotes alcohol
consumption in adolescents and young adults with acute pancreatitis: Analysis of an
international cohort of 2,335 patients
In pediatric acute pancreatitis (AP), a family history of pancreatic diseases is prognostic
for earlier onset of recurrent AP (ARP) and chronic pancreatitis (CP). No evidence
supports the same association in adult-onset pancreatitis. Age-specific reasons for
familial aggregation are also unclear. We aimed to examine the prognostic role of
pancreatic family history for ARP/CP and observe possible underlying mechanisms.We
conducted a secondary analysis of the Hungarian Pancreatic Study Group's (HPSG) multicenter,
international, prospective registry of patients with AP, both children and adults.
We compared the positive family history and the negative family history of pancreatic
diseases, in different age groups, and analyzed trends of accompanying factors. Chi-square
and Fisher exact tests were used.We found a higher rate of ARP/CP in the positive
pancreatic family history group (33.7 vs. 25.9%, p = 0.018), peaking at 6-17 years.
Idiopathic AP peaked in childhood in the positive family history group (75% 0-5 years)
and was consistently 20-35% in the negative group. A higher rate of alcohol consumption/smoking
was found in the positive groups at 12-17 years (62.5 vs. 15.8%, p = 0.013) and 18-29
years (90.9 vs. 58.1%, p = 0.049). The prevalence of diabetes and hyperlipidemia steadily
rose with age in both groups.Positive family history most likely signifies genetic
background in early childhood. During adolescence and early adulthood, alcohol consumption
and smoking emerge-clinicians should be aware and turn to intervention in such cases.
Contrary to current viewpoints, positive pancreatic family history is not a prognostic
factor for ARP and CP in adults, so it should not be regarded that way.
